We undertook an unannounced inspection of George Beal House on the 28 September 2017.

The service provides short breaks and respite care for up to 12 people who have some form of a physical disability or a learning disability. On the day of our inspection, there were eight people who were using the service.

At the last inspection, the service was rated good. At this inspection we found the service remained Good overall.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had supervision, support and effective training that enabled them to support people well. However, they did not always feel supported by the management team.

The provider had effective recruitment processes in place and there was sufficient staff to support people safely. Staff understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised and how to safeguard people from the risk of possible harm.

The provider had effective recruitment processes in place and there were sufficient staff to support people safely. Staff understood their roles and responsibilities and would seek people’s consent before they provided any care or support.

People were supported by caring and respectful staff who knew them well. Relatives we spoke with had described the staff as kind and caring. People were supported to go into the community and pursue their interests.

People had been assessed, and care plans took account of their individual needs, preferences, and choices. Staff supported people to access health and social care services when required.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people and acted on the comments received to continually improve the quality of the service. The provider also had effective quality monitoring processes in place to ensure that they were providing a quality service for people.

Further information is in the detailed findings below.

This inspection took place on 26 August 2015.

George Beal House provides respite and short break accommodation for people with either physical or learning disabilities. The service is provided in two linked bungalows in Kempston, near Bedford. The service has 12 beds, two of which are reserved for emergency respite placements. At the time of our inspection there were eight people using the service and, in total there were 74 people who regularly came in to use the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were cared for by staff that were knowledgeable about abuse and the forms that it may take. They were aware of the actions they should take to protect people and the procedures for reporting abuse.

Risks were managed appropriately. There were risk assessments for people and the general environment and these were updated regularly.

Incidents and accidents were reported and investigated and the service had plans in place to help manage incidents and emergencies.

There were sufficient levels of staff to meet people’s needs. Recruitment of staff was safe and robust, to ensure people were cared for by suitable members of staff.

People’s medication was well managed. Errors had been identified in the past and systems introduced to manage these.

Staff received regular training and supervision to give them the skills and support they needed to perform their roles.

The service sought the consent of people before providing them with care. Where people were unable to give consent or make their own decisions, the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards were followed.

People were supported to have a nutritious and balanced diet. Systems were in place to record people’s dietary intake if required.

People were supported to access health professionals both in the service and the local community.

There were positive relationships between people, their families and members of staff. People and their families were treated with kindness and compassion.

People were supported to express their own views and opinions about their care and there was information available to them in a range of different formats.

The independence, privacy and dignity of people was promoted by staff and they treated people with respect.

People and their families contributed to their care plans and they were updated regularly to ensure they were still accurate and relevant.

Systems were in place to obtain people’s view and opinions about their care. People were able to raise concerns or complaints with the service and felt that these would be acted upon.

The service had an open, positive and welcoming culture.

The service had a registered manager in post. They were supportive of people and staff and worked alongside them to ensure people received the correct care.

There was a range of quality control and audit procedures in place to help maintain high standards of care and identify areas for development.

The service provided at George Beal House was a residential respite service for people with learning disabilities. Many of the people had complex care needs. Most accessed the service on a planned respite basis usually for up to a week.

We found that people were supported to attend their usual day to day activities at various centres in Bedford while staying at George Beal House. People we spoke with told us they we able to go out and about with staff support if they wanted to. One person said "I can do what I want; I visit other people in the other unit, watch TV and spend time in my room. I like coming here."

People we spoke with told us they were supported and liked to stay at the unit. One person said "I like coming here; it's a good break for me." They also said "I get to go out and do things it's really good." We noted that people's cultural, spiritual and dietary needs were identified and plans put in place to meet these.

The medication system in place ensured that people's medication was appropriately managed in order to safeguard them from risks associated with medication management.

We found there was a staff team with the necessary skills and experience to meet people's complex needs.

The provider had put in place a robust quality assurance system. There was a manager for the service who was registered with the commission and the service was well led and responsive to people's needs.

People who used the service at George Beal House had varied needs.

Our observations during our visit to George Beal House on 29 January 2013 concluded that there was a very positive interaction between people who used the service, their carers and the staff team. People living there presented as relaxed and confident to approach staff. There was friendly speech, choice and respect in evidence and appropriate contact from staff toward people who used the service.

We saw people being supported to maintain and improve upon their skills. We observed people being included and involved in meal preparation so that people could see and smell meals being created. Family members were involved in planning the use of the service and decision making. George Beal House makes use of local shops and leisure opportunities and people living there are included within the local community. We saw that social activities take place regularly.

During our visit we observed that staff at George Beal House demonstrated a high level commitment to the people who used the service. We spoke to staff who reported that they enjoyed their work and who we observed delivered care in a dignified, respectful and committed manner.

Most of the people that we met during our visit on 17 November 2011 did not use words to communicate; so we spent some time observing the support being provided to them.

At tea time, we observed staff sitting alongside people and chatting to them, whilst they helped them with their meals. Assistance was provided at a relaxed pace.

People were supported to make choices about what and when to eat. Food that was offered, had packaging that allowed the person to see a picture of the food contained inside.

People were not routinely offered non breakable cups and plates. These were only provided as necessary.

We noted that staff were patient and kind and understood the needs of the people that they were supporting.